Page 428 - Critical Care Nursing Demystified

Chapter 9 CARE OF THE PATIENT WITH CRITICAL HEMATOLOGIC NEEDS 413

5 TABLE 9–5 Medications That Can Be Used in Hematologic Needs (Continued)

Medication Action Uses Precautions
Aminocaproic Hemostatic agent Disseminated 1. Avoid rapid infusion
acid (Amicar) helps control intravascular by regulating on IV
excessive bleeding coagulopathy pump
Inhibits (DIC) 2. Rapid infusion can
plasminogen cause dysrhythmias,
activator substance bradycardia, and
and plasmin hypotension
3. Change the
administration site
immediately if
extravasation or
thrombophlebitis
occurs
4. Can cause renal
failure; watch the
BUN, creatinine, and
urinary output
5. Report symptoms
of myopathy like
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myoglobinuria
6. Discontinue if signs
of DVT or PE develop
Anticoagulants See Chapter 3
medications
(see Table 3–9)
Dobutamine Increases cardiac Hypotension 1. Use infusion pump to
(Dobutrex) contractility by related to titrate continuous
stimulating beta-1 septic shock infusion according to
myocardial the HR and BP
receptors 2. Correct acidosis and
Increases CO and hypovolemia prior to
decreases PAOP initiating
Increases 3. Check the VS
conduction through frequently during
AV node initial therapy then
Decreases rhythm every 15 minutes
disturbances after stabilizing
4. If marked increase
in HR, BP, or
dysrhythmias,
decrease the dose